Success rate of silver nano-particles in comparison to silver diamine fluoride in management of deep carious lesions: a randomized controlled clinical trial / Taxa de sucesso de nanopartículas de prata em comparação ao fluoreto de diamina de prata no manejo de lesões cariosas profundas: um estudo clínico controlado randomizado

Objective: Evaluate the effectiveness of nanosilver fluoride in comparison to silver diamine fluoride in management of deep carious lesions. Material and Methods: This double-blinded randomized controlled clinical trial included thirty-six patients with deep carious mandibular molars. Patients were recruited form the outpatient clinic of Suez canal university, Egypt and randomly allocated into three groups, Nanosilver fluoride group, Silver diamine fluoride group and control group. For all groups, teeth were isolated by rubber dam. Access was done followed by partial caries removal. Silver diamine fluoride or Nanosilver fluoride were applied, and all teeth were restored with composite resin restorative. Patients were recalled after 3 and 6 months to follow-up the pulp vitality. R-statistical analysis software for Windows, version 4.1.1, was used to conduct the statistical analysis Results: At 3 month, for all groups, all teeth were successful. After 6 months, for silver diamine fluoride group, a single case failed. Regarding the nanosilver fluoride, all cases were successful. For the control group, two cases failed. No statistically significant difference was found between the tested groups. Conclusion: Application of 5% Nanosilver to fluoride varnish has similar clinical efficacy as silver diamine fluoride in arresting the dentin caries progression (AU)

Objetivo: Avaliar a eficácia de fluoreto de nanoprata em comparação ao fluoreto de diamina de prata no manejo de lesões profundas de cárie. Material e Métodos: Este estudo clínico controlado randomizado duplo-cego incluiu trinta e seis pacientes com lesões de cárie profunda em molares inferiores. Os pacientes foram recrutados no ambulatório da Universidade do Canal de Suez, no Egito, e alocados aleatoriamente em três grupos de tratamento: fluoreto de nanoprata, fluoreto de diamina de prata e grupo controle. Para todos os grupos, os dentes foram submetidos ao isolamento absoluto. O acesso à lesão foi feito seguido pela remoção parcial de tecido cariado. Tanto o fluoreto de diamina quanto fluoreto de nanoprata foram aplicados, e todos os dentes foram restaurados com resina composta. Os pacientes foram avaliados após 3 e 6 meses para o acompanhamento da vitalidade pulpar. O software estatístico R-statistical para Windows, versão 4.1.1, foi usado para as análises. Resultados: Em 3 meses, para todos os grupos, todos os dentes apresentaram sucesso no tratamento. Após 6 meses, para o grupo que utilizou o fluoreto de diamina de prata um único caso falhou. Em relação ao fluoreto de nanoprata, todos os casos apresentaram sucesso. Para o grupo controle, dois casos falharam. Não houve diferença estatística entre os grupos testados. Conclusão: A aplicação de verniz de fluoreto de nanoprata a 5% tem eficácia clínica semelhante ao fluoreto de diamina de prata na interrupção da progressão de cárie no tecido dentinário (AU)

The Effect of Polyacrylic Acid and Sodium Trimetaphosphate on Dentin Hybrid Layer Remineralization: An In Vitro Study.

Background: Adhesive monomers are not able to fully encapsulate collagen fibrils in hybrid layer leaving them vulnerable to time-dependent hydrolytic degradation. The current in vitro study was designed for investigation of the remineralization of the resin-dentin hybrid layer using biomimetic analogs by nanoleakage investigation. Material and Methods: Firstly, occlusal enamel of thirty human molars was removed exposing flat surface of dentin, then randomly divided into three main groups according to the different remineralizing protocols (n=10) (R): control group (R0), STMP group (R1), and biomimetic remineralizing group (R2). The dentin surface of the STMP and biomimetic remineralizing groups (R1 and R2) was treated with STMP solution, followed by self-etch adhesive application on dentin surface of all groups, and restored with double 2-mm thick layers of resin composite. Each tooth was sectioned perpendicularly to the resin-dentin interface for producing 1-mm thick slaps. Each group was subdivided into four subgroups according to the incubation time to 24 hours, one month, three months, and 4 months. Retrieved slabs were prepared for nanoleakage for evaluation of metallic silver particles distribution percentage at the resin-dentin interface using digital image analysis software. Results: There was a statistically significant increase in nanoleakage over time in all three groups. However, the third group showed the least increase in metallic silver uptake over time. Conclusions: Hybrid layer could be remineralized by using dual-biomimetic analogs (PAA and STMP). Key words:Hybrid layer, remineralization, nanoleakage, polyacrylic acid, sodium trimetaphosphate.

Effect of phytic acid on bond strength and interfacial integrity of universal adhesive to deep dentin.

This study investigated the effect of phytic acid (IP6) in different concentrations and application times on microtensile bond strength (µTBS) and interfacial integrity of universal adhesive to deep dentin. Flat deep dentin surfaces of 48 human molars were either etched with 37% phosphoric acid (PA) for 15 sec (control); or received no acid treatment and universal adhesive was applied directly in a self-etch mode (SE); or divided according to IP6 concentration (C) into two main groups: C1, 0.5%, and C2, 1%. Specimens of IP6 groups were further subdivided into three subgroups according to application time of IP6 (T) where; T1, 15 sec; T2, 30 sec and T3, 60 sec. Single Bond Universal Adhesive was then applied and resin composite blocks were built-up. Forty Specimens were then sectioned to produce resin/dentin beams that were used for µTBS testing using a universal testing machine. The remaining eight specimens were sectioned into slabs that were immersed into ammonical silver nitrate solution and nanoleakage was observed using a field emission scanning electron microscope (FE-SEM). The results showed that the application of IP6 in 0.5% and 1% produced significantly higher µTBS and less nanoleakage compared to PA and SE groups. Also, the application of IP6 for 60 sec recorded the highest µTBS and the lowest nanoleakage followed by 30 sec, and 15 sec respectively. Therefore, conditioning of deep dentin with IP6 enhances µTBS and interfacial integrity of universal adhesive to deep dentin in comparison to PA etching or using the universal adhesive in SE mode.

Effect of phytic acid on bond strength and interfacial integrity of universal adhesive to deep dentin

Abstract This study investigated the effect of phytic acid (IP6) in different concentrations and application times on microtensile bond strength (µTBS) and interfacial integrity of universal adhesive to deep dentin. Flat deep dentin surfaces of 48 human molars were either etched with 37% phosphoric acid (PA) for 15 sec (control); or received no acid treatment and universal adhesive was applied directly in a self-etch mode (SE); or divided according to IP6 concentration (C) into two main groups: C1, 0.5%, and C2, 1%. Specimens of IP6 groups were further subdivided into three subgroups according to application time of IP6 (T) where; T1, 15 sec; T2, 30 sec and T3, 60 sec. Single Bond Universal Adhesive was then applied and resin composite blocks were built-up. Forty Specimens were then sectioned to produce resin/dentin beams that were used for µTBS testing using a universal testing machine. The remaining eight specimens were sectioned into slabs that were immersed into ammonical silver nitrate solution and nanoleakage was observed using a field emission scanning electron microscope (FE-SEM). The results showed that the application of IP6 in 0.5% and 1% produced significantly higher µTBS and less nanoleakage compared to PA and SE groups. Also, the application of IP6 for 60 sec recorded the highest µTBS and the lowest nanoleakage followed by 30 sec, and 15 sec respectively. Therefore, conditioning of deep dentin with IP6 enhances µTBS and interfacial integrity of universal adhesive to deep dentin in comparison to PA etching or using the universal adhesive in SE mode.

Resumo Este estudo investigou o efeito do ácido fítico (IP6) em diferentes concentrações e tempos de aplicação na resistência da ligação microtensiva (µTBS) e na integridade interfacial do adesivo universal à dentina profunda. As superfícies planas de dentina profunda de 48 molares humanos foram preparadas com ácido fosfórico (PA) a 37% durante 15 seg. (controlo); ou não receberam tratamento ácido e o adesivo universal foi aplicado diretamente em modo de auto-adesivo (SE); ou dividido de acordo com a concentração de IP6 (C) em dois grupos principais: C1, 0,5%, e C2, 1%. Os espécimes dos grupos IP6 foram ainda subdivididos em três subgrupos de acordo com o tempo de aplicação do IP6 (T) em que; T1, 15 seg; T2, 30 seg e T3, 60 seg. Aplicou-se então Single Bond Universal Adhesive e construíram-se blocos compostos de resina. Quarenta espécimes foram então seccionados para produzir feixes de resina/dentina que foram usados para testes µTBS usando uma máquina de testes universal. Os restantes oito espécimes foram seccionados em placas que foram imersas em solução amoniacal de nitrato de prata e observou-se uma nano-infiltração utilizando um microscópio eletrônico de varrimento de emissões de campo (FE-SEM). Os resultados mostraram que a aplicação de IP6 em 0,5% e 1% produziu µTBS significativamente mais elevado e menos nano-infiltração em comparação com os grupos PA e SE. Além disso, a aplicação de IP6 durante 60 seg registou o µTBS mais alto e o mais baixo de nano-infiltração seguido de 30 seg, e 15 seg respectivamente. Portanto, o condicionamento da dentina profunda com IP6 melhora o µTBS e a integridade interfacial do adesivo universal à dentina profunda em comparação com a gravação de PA ou utilizando o adesivo universal no modo SE.